RISK-FACTORS FOR DEVELOPMENT OF DEHYDRATION IN YOUNG-CHILDREN WITH ACUTE WATERY DIARRHEA - A CASE-CONTROL STUDY

In a case-control study to understand the risk factors for development of life-threatening dehydration, a total of 379 children comprising 2 43 cases (moderate or severe dehydration) and 136 controls (non or mil d dehydration) up to 2 years of age suffering from acute watery diarrh oea were studied. By univariate analysis, the presence of vibrios in s tool, withdrawal of breast feeding during diarrhoea, not giving fluids , including oral rehydration solution (ORS), during diarrhoea, frequen t purging (> 8/day), vomiting (> 2/day) and undernutrition were identi fied as risk factors. However, by multivariate analysis after controll ing for confounders, withdrawal of breast feeding during diarrhoea (od ds ratio (OR) = 6.8, p < 0.00001) and not giving ORS during diarrhoea (OR = 2.1, p < 0.006) were identified as significant risk factors. The confounding variables which also contributed significantly to increas ing the risk were age (less than or equal to 12 months; OR = 2.7, p = 0.001), frequent purging (> 8/day; OR = 4.1, p < 0.00001), vomiting (> 2/day; OR = 2.4, p = 0.001) and severe undernutrition (%median less t han or equal to 60 weight-for-age of Indian Academy of Paediatrics cla ssification; OR = 3.1, p = 0.001). We feel that these findings will be useful for Global and National Diarrhoeal Diseases Control Programmes for formulating intervention strategies for preventing death due to d iarrhoeal dehydration.